When Justin Van’s family moved to Seattle from Vietnam, they spoke little English and his parents had no idea how to navigate the health care system here.

School-based health centers have become a lifeline for immigrant and refugee students like Justin, providing health services within steps of their classrooms. That proximity is critical. It helps build relationships with students and their families, not to mention saving working parents a day’s excursion to get their children to medical appointments.

The Teen Health Center at Seattle World School, where Justin attended high school, was there to help him with onsite medical care, dental care and behavioral health services provided by the International Community Health Services. Health center staff also assist students and their families with health insurance enrollment and connect with community resources.

What began in 1989 as a modest pilot program at Rainier Beach High School is now a model for an effective school-based health care system, serving over 10,000 elementary, middle and high school students each year across King County. ICHS was awarded the Seattle contract to provide services to a high school serving immigrant and refugee students (what would become SWS) in 2011. Today, SWS serves more than 1,000 students between the ages of 11 – 21.

The special health care needs of immigrant and refugee students

According to the National Institutes of Health, some of the most common barriers to accessing adequate health care for refugees and immigrants include: communication ability, financial resources, shame/stigma, knowledge about the health care system and fear of deportation. It’s no surprise that all of these factors result in vulnerability to poor health outcomes. Although refugees have access to free health care services from federally qualified health centers, nonprofit hospitals and General Assistance programs in Washington state, specialist care, like dentists and eye care, is often unaffordable.

One of the barriers to accessing health care information is literacy in students’ own language, stemming from the lack of opportunity for formal education in their countries of origin. Andrea Kurtzman, a school nurse at Seattle World School, has gotten creative with getting health information across to students. She put together a visual flyer about toenail hygiene after seeing six kids who had ingrown toenails, three who needed to have a nail surgically removed.

“When we sent home COVID home test kits with each student, we worried about how difficult it would be for many of them to understand how to use them,” Kurtzman says. She and a health care navigator, Mercedes, produced videos in English and Spanish demonstrating how to use the kits. Mercedes also created a flyer with a QR code for the video that was given to each students.

“All of these extra projects take a lot of time,” Kurtzman says. “It’s lots of little steps, trial and error to see what works.”

Justin Van, who graduated from Seattle World School, is now a patient navigator who works with Neighborhood House, a nonprofit that helps connect low-income, immigrant and refugee families to services that meet their basic needs. He works at the Teen Health Center and guides students through health center paperwork, helps them with the outside health care system, and connects their families to food banks and other resources like rental assistance and COVID relief funds.

And, he sometimes gets calls a bit further afield. “‘Oh, I moved to Texas, and I don’t know anybody in Texas. Can you please help me find a community clinic or any clinic nearby?’” Van recalls one client asking. It took a little searching, but the answer, of course, was “yes.”

Van sees his work as a way of giving back — ICHS was there for him and his family when they needed help. “ICHS has a very, very special place in my heart,” he says.

ICHS provides health care for everyone, regardless of income, insurance or immigration status. Affordable medical, dental, behavioral health, vision and pharmacy services with multilingual doctors, nurses and staff meet the needs of King County’s diverse and multicultural communities.